Involuntary Loss of Insurance Coverage

If you experience an involuntary loss of insurance coverage, you have 30 days to enroll in the BGSU-offered Student Insurance Plan and prevent a break in coverage.

Examples of involuntary loss of insurance include, but are not limited to:

• Reaching an age where you are no longer eligible for benefits under a parent/guardian's plan
• Divorce, marriage or death of your parent/guardian or spouse
• Loss of employment or change in employer benefit eligibility

What we will need from you...

1. Enrollment application which are available in the Student Insurance Office or by email request.
2. Letter of creditable coverage from former insurance carrier stating the date coverage was lost.
3. Make payment via Visa, Master Card, personal check or money order made payable to United HealthCare. This will be a pro-rated amount determined by the date on the letter of creditable coverage.

**You must be registered for at least 5 credit hours to be eligible for the BGSU-offered Student Insurance Policy.

Please visit the Student Insurance Office for an enrollment application or for more information.

Student Insurance Office
Room 170 Health Center Building 
Bowling Green, OH 43403-0147
Phone: 419-372-7495
Fax: 419-372-4812 
studentins@bgsu.edu